Oh no, I completely understand that it’s about the logistics. What I was getting at was more that should you go against your doctor’s advice, the insurance company might latch onto that as an excuse to not pay for the delivery and post-natal care. Incidentally, it’d be reasonably easy for me to find out the cost of going to Canada to have the baby there – a friend’s a practicing midwife in Ontario.
Though, I suspect, the first thing she’ll say is “I wouldn’t accept a patient whom I wasn’t going to see semi-regularly throughout the pregnancy.”
We are well clear of the pregnancy childbirth experience. It is an incredible, stressful thing. And everydamnbody has an opinion, maybe a book about it.
Figure out what you are comfortable with. Home, hospital, culvert - whatever works for you and yours. Midwife, doctor, NO, whatever. It is your experience to have.
Just don’t forget to plan for the day after the birth, which is when things get really interesting. You have just been through a singularly exhausting, possibly traumatic and definitely powerful experience and could really use a couple of weeks off. However, you now have a tiny, wholly dependent and utterly helpless human being in your care who has no concept of your exhaustion or anything else. That is overwhelming, and 9 years in I can say that it remains somewhat intense.
Now, a steady supply of NO for child rearing sounds like a novel idea.
Here’s why dentists (and hospitals almost certainly) stopped using nitrous – this from my dentist, who’s a meticulous researcher, some years ago: Nitrous caused a significant increase in miscarriages among dental staff
Nitrous works differently than other anesthetics – by binding to hemoglobin better than oxygen. You get giddy (or anesthetized) because you’re temporarily oxygen deprived, which is not good for your developing fetus.
So probably not a problem for mother or baby in labor, but a chronic, ongoing exposure for hospital personnel because it diffuses into the room so easily.
Pretty funny that it’s been out of use for so long that the rationale has mostly been forgotten.
I’ve also witnessed my wife give birth with no drugs whatsoever, twice. The first time, she was REALLY dedicated to doing it that way. The second time, she wanted to go that route again, but was prepared to ask for the epidural if the pain became too much (as it had been pretty rough the first time). As we arrived at the hospital the second time, she actually asked for the epidural, but she was already too far along so they wouldn’t give it to her.
If nitrous had been available, I think it would have been a very nice middle ground, particularly the second time. Her objection to the epidural wasn’t so much a principled objection to drugs or some wacky desire to prove what a bad-ass she is. It was an objection to all the restrictions on movement and activity that come with the epidural. My guess is that nitrous would come with restrictions on things like food and drink as well (they don’t want you puking in the middle of birth). But I imagine (from my male perspective) that there’s a big difference between taking a quick hit of nitrous during a particularly painful contraction and committing to paralyzing yourself from the waist down for the duration of the birth.
Tribune is right. The best advice is to listen to all advice and be informed but leave all your options open, and then, as the situation unfolds, make your informed decisions.
My dentist told me that since it’s an open system (people inhale through the nose mask, and can exhale through the necessarily-exposed mouth, even though there’s an exhale valve in the mask) he didn’t want patients exhaling nitrous in his face while he was trying to concentrate. I see his point.
I have a dentist I love, and for years I would get nitrous if he was drilling.
I changed dentists for a couple of years and when I went back, he told me they had stopped using nitrous because there were links to miscarriages in medical practices where it was used, and one of his staff had miscarried.
He offered me Valium instead, which works, except I need a ride home if I’m taking it.
I just Googled to check, and this was one of the first hits.
The story has it that “Painless Parker”, one of the first dentists to use NO2, developed a huge reputation – to the point where one dentist put up a sign:
A while ago at the L&D unit I work on, a patient who was from a town 4 hours away and 41 weeks along showed up in labor. She had apparently been visiting a friend. It was a nightmare getting her prenatal records from the other hospital and then getting a home health nurse to visit afterwards because she was out of our home health nurse care area. Why she was traveling so far when already a week overdue, I have no idea.
Really, no — we know as much about how Nitrous Oxide works as an anaesthetic agent as we do about the halogenated ethers we commonly use to maintain anaesthesia, ie. we don’t know completely, but have a reasonable idea. But Nitrous Oxide definitely doesn’t work like that. It did used to be used as a sole agent in so called ‘Black Gas’ anaesthetics, where hypoxia was part of what rendered the poor victim unconscious. But it is really insoluble and doesn’t preferentially bind to haemoglobin. If it did, a lot of my patients would have gone blue and died already and that hasn’t happened. And don’t worry, ‘Black Gas’ anaesthetics are an historical curiosity — Nitrous Oxide is delivered as a 50:50 mix with Oxygen for use as an analgesic. That’s too little N2O to anaesthetise the vast majority of people and more than enough oxygen for most too.
Our first birth experience was long and complicated, she had an epidural after about 7 hours and we only just managed to avoid a c-section.
For the second birth, my wife was pretty set on the epidural. However this one didn’t take quite so long. In fact from go to whoa was one hour and five minutes.
About half an hour in, there was a moment that is burned in my memory for ever. She was in pain and asked for the epidural, and they were paging the anaesthetist. Five minutes later the midwife came back and checked on her, hit the button for the nurse, and yelled “CANCEL THE ANAESTHETIST AND CALL THE DOCTOR!”
The Doctor didn’t make it in time, but the midwives did great.
There’s a dearth of good choices in dentistry and labour, and what you think is good or bad about them is a very personal thing. My sister was given pethidine too late, which meant that not oonly does she have no memory of her daughter’s birth, but the baby had to spend the first day in special care. Drugs from epidurals can affect the baby too, and may leave the mother with a terrible headache or sensation down one side of the body only, although the local hospital now offers ambulant epidurals which do have the advantage that you can walk around with them.
I had nitrous oxide for the birth of my first baby in the UK and absolutely hated it - where I was able to ride the pain of the contractions up to that point, using nitrous oxide made me lose all sense of where I was - I found it confusing and I didn’t find it took the edge off the pain either. I eventually had an epidural, and I think that was due to the loss of control I experienced on using nirtous oxide. For my subsequent two deliveries I used my TENS machine and breathing through the pain only.
I learned, through my own births and supporting two of my friends through labour, that good support, and having someone who can intepret for you when you cannot express yourself verbally, is far more important than any pain relief… and learning about yourself, about what you like and dislike about the process. I learned that I find making a LOT of noise very helpful - once I get past the breathing through the pain stage, making a noise helps me - one of the midwives told me that she can tell whether a woman is making progress and what stage of birth she is at, by the sounds she makes.
Nitrous oxide is probably one of those love it or hate it things, but I hated it, and didn’t use it again. So don’t be too sad about the lack of it in the US.
Anyone in the UK wondering whether to go to an antenatal class should note that it’s quite usual for the nitrous oxide to be passed round for everyone to have a huff. Partners too, not just the expectant mothers.
And don’t worry, ‘Black Gas’ anaesthetics are an historical curiosity — Nitrous Oxide is delivered as a 50:50 mix with Oxygen for use as an analgesic. That’s too little N2O to anaesthetise the vast majority of people and more than enough oxygen for most too.